Consequences for Skipping Weight Checks?

[Paige]

If a pediatrician recommends that your healthy (petite) child come in for a weight check, and you decide not to make an appointment for the weight check, will the pediatrician feel obliged to report it somehow or would it be a non-issue? My DD (4.5) is very petite but has always been on her own curve. Her new dr wanted to see her for a weight check but I feel it is unnecessary based on her family history, her own past history, and her previous pediatrician's advice. DD has not grown substantially since the previous appointment and I don't want her to be referred for unnecessary additional testing or specialists. Her siblings have all been small and I am well under the 3rd percentile myself. It's obvious why she's small and obvious that she is healthy, and I think new Dr is just trying to cover her butt and be safe. But- I don't want to be turned into CPS for medical neglect! Would that happen if we didn't make the follow up appt? This is a military clinic, if that matters. We've never dealt with them before.

[Slipper]

Our family has a history of petite kids. It's known that our kids will tend to be on the lower end of the growth chart and not very tall. :) Having said that, our pediatrician expressed concerns about our daughter's weight and we discovered that she had Celiac Disease (she's also a carrier for Cystic Fibrosis).

 

I would do the doctor's visit, but obviously I have a bias since my daughter had good reason for being low weight. We have had a lot of testing over the years, but she is 10 1/2 yrs old and weighs 52 pounds. I don't worry about new teachers, administrators, etc asking about her weight because we have medical documentation behind us that she is small for her age and that her Celiac still affects her growth in some way.

 

YMMV :)

[wapiti]

No, I wouldn't skip it (but then, we have many weird medical issues in our family; in fact, someone's due for a weight check now - thanks for reminding me). Our ped doesn't care much if they're at or even below the 3rd percentile, for example (as has happened in our family), but when that percentile curve rises over time but the kid's curve is more of a straight line, that's when she gets concerned.

 

If you decide to skip it, I don't think anyone's going to notice until the next annual well checkup rolls around, or you take your child in for a sick visit, at which time the growth will be checked anyway. I don't think there's need to feel defensive about this - if a doc gets concerned enough to bring up actual testing, that would be the time for a conversation, but a weight check alone is not something I'd seek to avoid.

[SweetBean]

I probably wouldn't skip it, largely because of concern about being reported. I went through this with my DD. She had to go in for more frequent weight checks, because she is tall and VERY thin. Even though I explained to the Dr. that I was even thinner at her age, she still wanted the checks. I just went ahead and did it. DD has finished the steep part of her growth curve, and the pediatrician has relaxed.

[Beth S]

DIY? Can you not weigh your child at home each month, and make a nice chart or graph which would impress your pediatrician at your next visit?

 

(I have no experience in this area.):)

[bookfiend]

Can't you decline with the explaination that your family is proud to be in the 5th percentile?

[fairy4tmama]

When my youngest was a baby we were asked to come in for a weight check while we didn't have ins. I called and asked if we were just going to come in and be weighed by a nurse and leave and what the cost would be (as I felt it was not necessary ) I was told it would be akin to a well child visit (more then 120 bucks:001_huh: for what I felt was unnecessary as she was gaining,albeit slooowwly) So I asked to speak to a nurse and had them note in her chart that I had weighed her at home and what her weight was and that was that.

[SKL]

I agree, why can't you just call in her weight? Why should you have to pay a ridiculous amount of money, waste time, and expose your child to doctor's office germs just so they can check something off their follow-up list? I would not go unless I had some other reason to talk to the doctor.

 

I have never heard of the authorities taking a child for this kind of reason alone.

 

My petite kid is on her own growth curve, too. She is extremely healthy. I dare anyone to try to take me to task over her weight.

[LucyStoner]

Can you find a pediatrician who is more used to small kids/not recommending interventions? You are small, your other kids are small. Unless there is a health issue that you are ignoring, I don't see what report the ped could make. The ped works for you, not the other way around. If you don't consent to non-necessary treatment or evals, you don't consent.

[Alice]

I'm a pediatrician. I've never reported anyone to CPS for failure to follow up for a well child check or weight check. If I was very concerned and you didn't show I would call you to discuss it or if for some reason I was unable to reach you by phone I might send a letter detailing my concerns.

 

Did you talk to your doctor about your feelings? I've had similar situations where I'm seeing someone new and I'm concerned about weight just by the growth curve only to have the parents say pretty much what you said in your post. Usually, I'd be reassured and ok with doing nothing with that kind of history. It's hard when seeing someone new especially to walk the line between overtreating and undertreating. Typically, we doctors prefer to err on the overtreatment side as we don't want to miss something.

Edited January 20, 2012 by Alice

[abbeyej]

I would push for the doctor to write "familial short stature" or "constitutional growth delay" (and note that there's a family history) on her chart. As long as she *is* growing, given your family history, this should not be an ongoing issue.

[Supertechmom]

All of our weight/height checks were freebies as that is the dr's policy. the nurse would run us back to a room, take us to the scale and record the measurements and we were on our way. No biggie and nothing was ever said unless something drastic was seen (like when my daughter dropped in a straight line down the chart LOL) I would go if it was free and not going to be an issue.

[NittanyJen]

New doc... Maybe she just sees something a little atypical (short stature) and it's an excuse for a healthy "getting to know you" handshake visit before you have to come in with an emergency? It could be very non-threatening.

[scholarly]

I skipped an infant weight check in favor of weighing at home. I had no problems and the doctor didn't mention it at the next visit. It was a moot point by then, as the baby had gained.

[TravelingChris]

If this is at a military clinic, then it is free. So maybe I would do it but then try to get switched to another doctor. I had these same problems though mine weren't quite that thin. I had one doctor get on my case and tell me I wasn't doing well because I had been giving my kid orange juice instead of grape juice and that kind of thing. I got another doctor. He was Asian and understood when I said my kids are just skinny like I was when I was young. They were all somewhere between 10-20% so no one should have been fretting. They were always on the right curve and not falling so it really was okay.

[Paige]

Yes, it's free. It's just a headache to take time off school, drive there (40min one way), get a babysitter or bring everyone else, and I know there is no problem. We cannot go off post. Two of the other kids have actual special needs right now causing us to go to different doctors 2-3 times a month at a minimum and probably more often shortly, and I just don't want to go to any more. I could call and report the weight, but as I'd be reporting no weight gain...I think I'd rather say nothing for now. I still don't think it's unusual for 4yr olds to not gain much weight over 4-6 months. I think my other kids only gained 1 or 2lbs from 4-5 and very little again each year from then on. DH said we should skip it but I was a little concerned that the military clinic would be more uptight about it. I don't want anything noted in my chart like, "Parent disregards advice and doesn't follow through." :tongue_smilie: I actually like how this Dr treats my other small kids and don't dislike her at all.

[Ottakee]

I would say too that it depends on how long ago her last appointment was. If she didn't grow and it had been 12 months that is more worrisome then if it had been just 8 weeks ago.

 

Maybe you can just weigh and measure her once a month and call it in or just keep a log yourself.

 

I am one though that has 2 girls that are very small. At 4 1/2 the one wasn't growing very fast, etc. We did follow up with an endocrinologist and found that she was hypothyroid and that she needed a thyroid med. She then did grow but at 16 she is still only 4'10" and 95 pounds.